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Localized melioidosis in children in Thailand: treatment and long-term outcome

Pagakrong Lumbiganon1, Napaporn Chotechuangnirun, Pope Kosalaraksa

  • 1Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. paglum@kku.ac.th

Journal of Tropical Pediatrics
|September 8, 2010
PubMed

Insights

Localized melioidosis in children, caused by Burkholderia pseudomallei, often presents as skin infections or parotitis. Trimethoprim-sulfamethoxazole, with or without doxycycline, showed effective oral eradication with no adverse effects in this pediatric study.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Melioidosis, caused by Burkholderia pseudomallei, is a significant infection with varied presentations, including severe septicemia and localized forms.
  • Optimal antibiotic regimens for localized pediatric melioidosis remain under-researched, highlighting a critical knowledge gap in pediatric infectious disease management.

Purpose of the Study:

  • To investigate the clinical presentation, treatment strategies, and long-term outcomes of localized melioidosis in pediatric patients.
  • To evaluate the efficacy and safety of oral antibiotic regimens for localized melioidosis in children.

Main Methods:

  • A retrospective review of 37 pediatric cases of localized melioidosis treated between 1994 and 2006.
  • Prospective follow-up of patients until October 2007 to assess treatment outcomes and long-term results.

Main Results:

  • The most frequent clinical presentations were skin/soft tissue infections and suppurative parotitis.
  • Oral antibiotic regimens, primarily trimethoprim-sulfamethoxazole alone or with doxycycline, were used for eradication after initial parenteral therapy or as primary treatment.
  • No adverse effects were reported during the treatment period, and 31 out of 32 followed-up patients recovered fully, with one reporting a possible relapse.

Conclusions:

  • Localized melioidosis in children commonly manifests as skin/soft tissue infections or suppurative parotitis.
  • Trimethoprim-sulfamethoxazole, with or without doxycycline, appears to be an effective and safe oral eradication regimen for localized pediatric melioidosis.
  • Further research into long-term outcomes and potential relapses is warranted for comprehensive management strategies.

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